Clusters of multimorbidity across hospital services and by language groups

Objective: Documenting multimorbidity profiles and resource use across hospital sectors can help inform and improve healthcare delivery. The purpose of this cohort study (2013-2017) was to describe profiles of multimorbidity among patients at an acute care hospital in Ontario, Canada. Methods: This was a retrospective cohort study over five fiscal years. Data from patients who were admitted as inpatients, visited the emergency department (ED), or received day surgeries at an acute care hospital in Ottawa, Canada between 2013 and 2017 were obtained from two individual-level administrative databases. Diagnoses for 13 chronic diseases and clusters of multimorbidity were identified using validated methods. The analysis sample was comprised of 22,932 patients with multimorbidity aged 18 years or over. Demographic (e.g., age) and clinical (e.g., ED visit count) characteristics of chronic disease clusters were examined across inpatient, ED, and day surgery services, and between language groups. Results: The most common disease profiles encompassed hypertension, diabetes, and arthritis. Mental health and mood conditions were highly concomitant among ED patients. Degree of multimorbidity was significantly associated with length of stay (LOS) and frequency of ED visits. Compared to Anglophone inpatients, hospitalized Francophone patients had significantly more comorbid conditions. Conclusions: Treatment plans should be tailored for different types of hospital services and will need to be patient-centered to account for variability in disease clusters, sociodemographic factors, and acuity levels. More studies are needed to understand the impacts of multimorbidity on healthcare systems.